MEDICARE: DR. AARON MATTHEW BOGART D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	OP61309353	WA
2	2083A0100X	Aerospace Medicine Physician	DO.000453	LA
3	2085R0202X	Diagnostic Radiology Physician	OP61309353	WA

General Provider Information

NPI Number	:	1396053666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON MATTHEW BOGART D.O.

Provider Business Mailing Address
First Line	:	PO BOX 50095
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98145-5095
Country	:	US
Telephone Number	:
Fax Number	:	318-675-5069

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-0001
Country	:	US
Telephone Number	:	206-520-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	04/10/2026

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